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Atrial Fibrillation - May '08
Atrial Fibrillation: Striving for a cure
James Maloney, MD
Atrial fibrillation (afib or AF) is a big term that’s used to describe a simple concept: a heart rhythm abnormality. Afib is a major medical condition that is becoming more of a problem as our population ages. With nearly 170,000 new cases developing each year, afib puts a large number of Americans at risk for stroke and even congestive heart failure.
“Afib is most common in patients age 65 and older, but it can occur in populations as young as age 20,” says James Maloney, MD , co-director of the Center for Atrial Fibrillation Ablation at The University of Toledo Medical Center. “With afib, the heart’s two small upper chambers quiver instead of beating properly.” Because of the rhythm abnormality, blood isn’t pumped through the body effectively and can cause clots. If a blood clot moves to the brain, a stroke may occur, which is the case about 15 to 20 percent of the time.
To help avoid a life-threatening stroke, it’s important to recognize the warning signs of afib. “Symptoms include fatigue, shortness of breath, palpitations, chest pains, hypertension and sometimes fainting,” says Dr. Maloney. “To use an analogy: If you have an eight-cylinder car and you take four cylinders out, the car isn’t going to perform very well. That’s what afib does to a patient.” Often, active young individuals ignore symptoms and continue activities, despite a racing heart. “This is a bad idea, because if left untreated, afib can develop into severe congestive heart failure in a matter of months,” he says. “Fortunately, if we treat patients vigorously and bring their heart rate under control, their heart recovers almost fully.”
Family history is a major risk factor and can mean the difference between developing the condition in your 60s versus your 30s. Other risks include: larger body mass, high blood pressure, diabetes and all forms of heart disease. “Maintaining normal blood pressure and a healthy weight can help prevent other diseases that may lead to afib,” Dr. Maloney says. “Sometimes it is a chain reaction.”
In order to diagnose afib, patients must see their physician during palpitation episodes. “When afib begins, it is usually episodic and we can’t diagnose it if we see patients with normal rhythms,” Dr. Maloney says. “Nevertheless, we can give patients monitoring tools that track their episodes for a month.” From these tools, physicians can see how long and severe the rhythm abnormalities are and then initiate a treatment plan.
Although most patients are put on blood thinners to help reduce the risk of stroke, the rest of the treatment plan is individualized. The three most common therapies include:
- Heart rate and/or heart rhythm control medications
- Heart rate control, in combination with ablation procedures, minimally invasive procedures that destroy the faulty tissues, and a pacemaker to regulate heart rhythm
- Catheter (non-invasive) and surgical-based ablation techniques for afib that doesn’t respond to medication
The UT Medical Center is the only facility in northwest Ohio that offers comprehensive care for patients with atrial fibrillation, including ablation procedures.
Dr. Maloney has been actively treating patients with afib since 1998 for both long- and short-term medical management with catheter and surgical innovations. “Our team at UT Medical Center is pushing the envelope and advancing medical science by treating patients more effectively than they were a decade ago,” says Dr. Maloney.
For more information on atrial fibrillation or to schedule an appointment with a university-quality physician, call 877-451-2299.
